Provider Demographics
NPI:1225553746
Name:GARVEY, KATHY
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:GARVEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 BEAU LAC LN
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-1456
Mailing Address - Country:US
Mailing Address - Phone:504-453-3253
Mailing Address - Fax:
Practice Address - Street 1:3801 N CAUSEWAY BLVD STE 303
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-1756
Practice Address - Country:US
Practice Address - Phone:504-453-3253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-05
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2774133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered